The recommended starting dose for olanzapine is 10 mg/day.
Manic episode: The starting
dose is 15 mg as a single daily dose in monotherapy or 10 mg daily in
Preventing recurrence in
bipolar disorder: The recommended starting dose is 10 mg/day. For
patients who have been receiving olanzapine for treatment of manic
episode, continue therapy for preventing recurrence at the same dose.
If a new manic, mixed, or depressive episode occurs, olanzapine
treatment should be continued (with dose optimisation as needed),
with supplementary therapy to treat mood symptoms, as clinically
During treatment for
schizophrenia, manic episode, and recurrence prevention in bipolar
disorder, daily dosage may subsequently be adjusted on the basis of
individual clinical status within the range 5-20 mg/day. An increase
to a dose greater than the recommended starting dose is advised only
after appropriate clinical reassessment and should generally occur at
intervals of not less than 24 hours.
Olanzapine can be given
without regard for meals, as absorption is not affected by food.
Gradual tapering of the dose should be considered when discontinuing
A lower starting dose (5
mg/day) is not routinely indicated but should be considered for those
65 and over when clinical factors warrant.
and/or hepatic impairment
A lower starting dose (5 mg)
should be considered for such patients. In cases of moderate hepatic
insufficiency (cirrhosis, Child-Pugh class A or B), the starting dose
should be 5 mg and only increased with caution.
The starting dose and dose
range need not be routinely altered for non-smokers relative to
smokers. The metabolism of olanzapine may be induced by smoking.
Clinical monitoring is recommended and an increase of olanzapine dose
may be considered if necessary.
When more than one factor is
present which might result in slower metabolism (female gender,
geriatric age, non-smoking status), consideration should be given to
decreasing the starting dose. Dose escalation, when indicated, should
be conservative in such patients.
In cases where dose increments
of 2.5 mg are considered necessary, ZYPREXA coated tablets should be
Olanzapine is not recommended
for use in children and adolescents below 18 years of age due to a
lack of data on safety and efficacy. A greater magnitude of weight
gain, lipid and prolactin alterations has been reported in short-term
studies of adolescent patients than in studies of adult patients.
[Summary of Product Characteristics]. Utrecht, The Netherlands: Eli
Lilly Nederland B.V.